Types Based On The Cancer’s Genes Or Hormones
When you’re diagnosed with breast cancer, your doctor will test your cancer cells to see whether they grow in response to hormones like estrogen or progesterone, or if they contain certain genes. These tests help your doctor find the treatment that works best against your cancer.
HER2-positive. About 1 out of every 5 breast cancers tests positive for human epidermal growth factor receptor 2 . This protein helps cancer cells grow. HER2-positive breast cancers are often more aggressive than other types. A group of drugs that include pertuzumab and trastuzumab are effective against these cancers.
Hormone receptor-positive or negative. Some breast cancer cells have areas on their surface that attach to the hormones estrogen or progesterone . These hormones help the breast cancer cells grow:
- ER-positive breast cancers have estrogen receptors.
- PR-positive breast cancers have progesterone receptors.
- Hormone receptor-positive means the cancer has one or both of these hormone receptors.
- Hormone-receptor negative means the cancer doesn’t have ER or PR receptors.
Triple negative. Around 15% of breast cancers are this type. Triple-negative breast cancer doesn’t have receptors for estrogen, progesterone, or HER2. This makes it harder to treat.
Once you learn your breast cancer type, ask your doctor what it means for your outlook and what medicines are available to treat it.
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CDC: “How is Breast Cancer Treated?” “Triple-Negative Breast Cancer.”
What Is The Prognosis For Invasive Ductal Carcinoma
Your doctor will discuss what you can expect based on the characteristics of the invasive ductal carcinoma and the effectiveness of your treatment.
Specialty centers such as Johns Hopkins Medicines Breast Health Services can offer integrated teams of breast cancer specialists who have skill and experience in surgery, breast reconstruction, chemotherapy, biologic targeted therapy, radiation therapy and other hormonal therapies.
Medical science is making great strides forward in treating breast cancer, allowing our surgeries to be less invasive and improving surgical outcomes and overall quality of life, Wright says.
Why Radiation Is Used
One of the upsides of using radiation is that it can be used to treat breast cancer at almost every stage. Its most often used in conjunction with surgery, chemotherapy, and other medicines to prevent breast cancer from coming back. And for incurable cases such as when the cancer has spread to other parts of the body its commonly used to ease symptoms.
But, unlike other forms of treatment, radiation is generally localized, meaning its usually aimed at only the part of the body thats needing therapy. In many cases, patients might just need radiation to a part of the breast or partial-breast irradiation where internal or external radiation is directed toward the area around where the cancer was removed.
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Other Types Of Breast Cancer
There are some other less common types of invasive breast cancer.
Invasive lobular breast cancer
About 1 in 10 invasive breast cancers start in the lobes of the breast. This type can sometimes be difficult to diagnose on a mammogrambecause of the way it grows. Some women may need an MRI scan.
Inflammatory breast cancer
This is when cancer cells grow along and block the tiny channels in the skin of the breast. The breast then becomes inflamed and swollen. Inflammatory breast cancer is rare.
Pagets disease of the breast
This is a condition that causes a red, scaly rash on the skin of the nipple. Women with Pagets disease of the breast may have DCIS or invasive breast cancer.
Kinds Of Breast Cancer
The most common kinds of breast cancer are
- Invasive ductal carcinoma. The cancer cells begin in the ducts and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
- Invasive lobular carcinoma. Cancer cells begin in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
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What Is Lobular Carcinoma In Situ What Is Atypical Lobular Hyperplasia
Lobular neoplasia is when there are abnormal cells in the breasts lobules . It rarely becomes cancer. Types of lobular neoplasia include:
- Lobular carcinoma in situ , a condition that is not breast cancer or a precancer. Often, it does not become invasive cancer if its not treated.
- Atypical lobular hyperplasia , a condition that is not cancer. Its when there are more cells than usual in your breasts lobules . The extra cells are abnormal.
Both LCIS and ALH raise your risk of getting breast cancer in the future. If you have been diagnosed with either of them, talk with your doctor. Ask how often you should bescreened for breast cancer and if you should have more screening tests.
Us Cancer Statistics Data Visualizations Tool
The Data Visualizations tool makes it easy for anyone to explore and use the latest official federal government cancer data from United States Cancer Statistics. It includes the latest cancer data covering the U.S. population.
See how the rates of new breast cancers or breast cancer deaths changed over time for the entire United States and individual states.Links with this icon indicate that you are leaving the CDC website.
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Types Of Invasive Breast Cancers
Invasive ductal breast cancer
About 8 out of 10 invasive breast cancers are this type. The cancer develops in the milk ducts of your breast, but breaks out of the duct tubes, and invades, or infiltrates the surrounding tissue of the breast and possibly other areas of the body.
It is usually treated with surgery, often followed by chemotherapy or radiotherapy. Read more about how breast cancer is treated.
The best treatment plan for you will also depend on if your cancer is helped to grow by hormones or particular proteins .
- Oestrogen receptor and progesterone receptor positive cancers are encouraged to grow by the female hormones oestrogen or progesterone. Read more about ER positive breast cancer.
- HER2 positive breast cancer means that the tumour produces too much of a protein called HER2, which helps breast cancer to grow. Read more about HER2+ breast cancer.
- Triple negative breast cancer doesnt have receptors for HER2, oestrogen or progesterone. More about triple negative breast cancer.
Other types of invasive breast cancer:
Rarer types of invasive breast cancer:
Medullary breast cancer, mucinous breast cancer, tubular breast cancer and malignant phyllodes tumours are rare types of breast cancer.
Trends In Breast Cancer Deaths
Breast cancer is the second leading cause of cancer death in women. The chance that a woman will die from breast cancer is about 1 in 39 .
Since 2007, breast cancer death rates have been steady in women younger than 50, but have continued to decrease in older women. From 2013 to 2018, the death rate went down by 1% per year.
These decreases are believed to be the result of finding breast cancer earlier through screening and increased awareness, as well as better treatments.
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Additional Types Of Invasive Ductal Carcinoma:
There are four types of invasive ductal carcinoma that are less common:
- Medullary Ductal Carcinoma This type of cancer is rare and only three to five percent of breast cancers are diagnosed as medullary ductal carcinoma. The tumor usually shows up on a mammogram and it does not always feel like a lump rather it can feel like a spongy change of breast tissue.
- Mucinous Ductal Carcinoma This occurs when cancer cells within the breast produce mucous, which also contains breast cancer cells. The cells and mucous combine to form a tumor. Pure mucinous ductal carcinoma carries a better prognosis than more common types of IDCs.
- Papillary Carcinoma This is a very good prognosis breast cancer that primarily occur in women over the age of 60.
- Tubular Ductal Carcinoma This is a rare diagnosis of IDC, making up only two percent of diagnoses of breast cancer. The name comes from how the cancer looks under the microscope like hundreds of tiny tubes. Tubular breast cancer has an excellent prognosis.
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The Importance Of The Clinical Trial In Breast Cancer Treatment
First, you need to understand what clinical trials are.
Clinical trials are research designed to study new tests and treatments and examine their effects on humans while tracking the results. For example, in the case of breast cancer, clinical trials are done to figure out new ways to improve tests and treatment options for this condition.
Clinical trials are beneficial to participants in two ways. First, they offer them the chance to get new, potentially advanced treatment. Secondly, they add to breast cancer research studies that may help enhance breast cancer treatment for other patients. People eligible for treatment clinical trials are those who are yet to receive any medical therapy for breast cancer.
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Types Based On Where Cancer Starts Or Spreads
One of the ways doctors describe breast cancer is based on where in your body it starts or spreads.
Carcinoma and Adenocarcinoma. Carcinomas start in the tissues that line your breasts and other organs. Most breast cancers are carcinomas.
Breast cancers are often a type of carcinoma called an adenocarcinoma. These cancers start in the cells lining the milk ducts or the glands that produce milk .
Ductal Carcinoma. Ductal carcinoma is cancer of the cells that line the milk ducts in your breast.
Ductal carcinoma in situ is the earliest form of ductal carcinoma. “In situ” means it’s only in the milk ducts, and isn’t likely to spread to other parts of your body. About 1 in 5 people who are newly diagnosed with breast cancer have DCIS. This type is very curable.
Invasive ductal carcinoma is the most common type of breast cancer, affecting about 80% of people who are diagnosed. “Invasive” means the cancer is able to spread outside of the milk duct where it started.
There are several subtypes of invasive ductal carcinoma:
You might also hear about lobular carcinoma in situ . But LCIS isn’t really cancer, and won’t spread outside of the lobule. Doctors usually find it when they do a breast biopsy.
Phyllodes Tumor of the Breast. These rare tumors grow in the breast’s connective tissue. They’re more common in women who have an inherited condition called Li-Fraumeni syndrome. Only 1 in 4 phyllodes tumors are cancer. The rest are noncancerous .
About Metastatic Breast Cancer
Cancer begins when healthy cells change and grow out of control, forming a mass or sheet of cells called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.When breast cancer is limited to the breast and/or nearby lymph node regions, it is called early stage or locally advanced. Read about these stages in a different guide on Cancer.Net. When breast cancer spreads to an area farther from where it started to another part of the body, doctors say that the cancer has metastasized. They call the area of spread a metastasis, or use the plural of metastases if the cancer has spread to more than 1 area. The disease is called metastatic breast cancer. Another name for metastatic breast cancer is âstage IV breast cancer if it has already spread beyond the breast and nearby lymph nodes at the time of diagnosis of the original cancer.
Doctors may also call metastatic breast cancer advanced breast cancer. However, this term should not be confused with locally advanced breast cancer, which is breast cancer that has spread to nearby tissues or lymph nodes but not to other parts of the body.
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What Are The Symptoms Of Bone Metastases
Often, first signs of bone metastases are aches and pains that are strong and unexplained. These pains can be caused by the metastases themselves, or by a bone break or fracture. For many people, any unexpected symptom after a cancer diagnosis can trigger fear and anxiety. This is completely understandable, and if this is you, youre not alone. Knowing that aches and pains are a major symptom of bone metastases may add to this stress, because everyone cancer or not has aches and pains from time to time.
It can be hard to know when a new ache is cancer-related. These symptoms may not immediately seem like cancer because there are many health issues that cause aches and pains, including menopause, breast cancer treatments such as aromatase inhibitors, or diseases like arthritis. And there are many ways to break or fracture even the strongest bones. The most important thing for you to do is to let your doctors know if youre feeling something out of the ordinary so that they can reassure you, or order tests to look into symptoms you experience.
A serious, though rare, complication of bone metastasis is spinal cord compression. In spinal cord compression, a dangerous amount of pressure is put on the spinal cord, a column of nervetissue that sends signals from the brain to the muscles. Symptoms can include:
- Lower back pain
- Burning pain that runs down the arms or back of the legs
- Numbness in the arms, legs, hands, or feet
- Trouble urinating
- Feeling constipated
What Is Invasive Lobular Carcinoma
Invasive lobular carcinoma starts in the breasts lobules. These are small round sacs that make breast milk. This cancer spreads to nearby tissue. ILC is the second most common type of invasive breast cancer, after invasive ductal carcinoma. Out of every 100 cases of breast cancer, 10 to 15 are ILC.
People who have ILC may notice a thick or full area that does not feel like the rest of the breast. ILC doesnt always form a lump.
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How Breast Cancer Type Affects Treatment
Breast cancer is not a one-size-fits-all disease. Therefore, neither are breast cancer treatment options. It is crucial to determine which hormones, if any, are involved in the growth of your breast cancer. Typically, your treatment plan will be personalized, based on your specific type, biomarkers, and stage of breast cancer.
Your WVCI oncologist will run some tests that indicate the hormone receptor status and HER2/neu status of your breast cancer tumor. These results will play a significant role in the kind of breast cancer treatment we recommend.
Enhancing Healthcare Team Outcomes
After the treatment of breast cancer, long-term follow-up is necessary. There is a risk of local and distant relapse, and hence an interprofessional team approach is necessary. The women need regular mammograms and a pelvic exam. Also, women with risk factors for osteoporosis need a bone density exam and monitoring for tumor markers for metastatic disease. For those who are about to undergo radiation therapy, a baseline echo and cardiac evaluation are necessary. Even though many types of integrative therapies have been developed to help women with breast cancer, evidence for the majority of these treatments is weak or lacking.
Outcomes
Over the past four decades, the survival rates of most breast cancer patients have improved. Of note is that the presence of breast cancer has gradually slowed down over the past decade, which may be due to earlier detection and improved treatments. The prognosis for patients with breast cancer is highly dependent on the status of axillary lymph nodes. The higher the number of positive lymph nodes, the worse the outcome. In general, hormone-responsive tumors tend to have a better outcome. In breast cancer survivors, adverse cardiac events are common this is partly due to the cardiotoxic drugs to treat cancer and the presence of traditional risk factors for heart disease. The onus is on the healthcare provider to reduce the modifiable risk factors and lower the risk of adverse cardiac events. [Level 5)
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Pearls And Other Issues
Breast cancer patients are advised to be followed up for life to detect early recurrence and spread. Yearly or biannual follow-up mammography is recommended for the treated and the other breast. The patient must be informed that they must visit a breast clinic if they have any suspicious manifestations. Currently, there is no role for repeated measurements of tumor markers or doing follow-up imaging other than mammography.
Tests To Monitor Bone Metastases
We know that it can feel frightening to think about the possibility of weaker bones or bone pain. It can mean changing your routine or avoiding activities youre used to. But there are always adjustments that can be made to allow you to live a life that is active and fulfilling in many different ways.
Your care team will monitor the bone metastases regularly to control the cancer and to help you figure out what your body can handle as you have treatment. Your doctors may use some of the same tests to monitor bone metastases that were used to diagnose them. This will likely include imaging tests that create pictures of your bones, such as x-rays, CT scans, MRIs, PET scans, and bone scans.
Your doctors may also order blood tests to monitor bone metastases:
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